Shelby Rose Pehlke

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

3005 NE Diamond Lake Blvd
Roseburg, OR 97470-3609

Phone

(541) 440-3532

Fax

(541) 440-3554

NPI assigned

Apr 1, 2025

Last updated

Jul 21, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• New Summit Behavioral Therapy, LLC

  • Behavior Analyst
  • Eugene, OR
  • NPI 1689203515

  Behavior Technician

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1743465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753056000000",
    "number": "1477357325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1121",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974700254",
            "telephone_number": "541-672-2691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3005 NE DIAMOND LAKE BLVD",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974703609",
            "telephone_number": "541-440-3532",
            "fax_number": "541-440-3554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEHLKE",
        "first_name": "SHELBY",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-01",
        "last_updated": "2025-07-21",
        "certification_date": "2025-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Imani Renee Payton, LPCC
• Tiffany Paz
• Trisha Joann Pederson
• Mark Pedginski
• Misha Marie Peel, DO
• Mark Pequignot, DNP FNP
• Alexia Jannet Perez, MSW,MS,LCSW
• Armando Perez
• Jody Perkins, RDH
• Jaimie Perry

• Mental Health Counselor in Roseburg, OR
• Providers in Roseburg, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.